摘要
先天性动静脉畸形(AVM)是一种由小动脉和小静脉连接而造成的搏动性血管瘤,先天性的血管瘤并不常见,仅占所有血管畸形的1.5%,且大多数发生在成人之前。通常情况下接近100%的AVM会随着时间的推移而发展,血管瘤的突然扩张会导致病灶区域扩张、邻近区域坏死、感染和出血,广泛AVM可引起一系列病理生理改变,包括心脏前负荷增加、代偿性心脏肥大、肺动脉高压甚至心力衰竭等。尽管临床上有关于AVM的病例报道,但对于合并心功能不全的四肢巨大AVM的治疗仍缺乏系统讨论和深入研究。此类患者的治疗措施为结扎相关动脉,但这一关键治疗手段会导致患者血流动力学发生剧烈波动,对于麻醉医生而言,围手术期患者的麻醉管理也极具挑战性。
Congenital arteriovenous malformation(AVM)is a pulsatile hemangioma caused by the connection between small arteries and small veins.Congenital hemangiomas are not common,accounting for only 1.5%of all vascular malformations,and most of them occur before adulthood.Usually,nearly 100%of AVMs will progress over time.The sudden expansion of the hemangioma can lead to the expansion of the lesion area,necrosis of the adjacent area,infection,and bleeding.Extensive AVM can cause a series of pathophysiological changes,including an increase in the preload of the heart,compensatory cardiac hypertrophy,pulmonary hypertension,and even heart failure.Although there are clinical case reports about AVM,there is still a lack of systematic discussion and in-depth research on the treatment of massive AVMs in limbs combined with heart failure.The treatment measure for such patients is to ligate the relevant arteries,but this key treatment method will lead to drastic fluctuations in the patient’s hemodynamics.For anesthesiologists,the perioperative anesthesia management of patients is also very challenging.
作者
李庆国
胡敬利
曲歌曲
李杨
史斌
秦中平
LI Qingguo;HU Jingli;QU Gequ;LI Yang;SHI Bin;QIN Zhongping(Department of Anesthesiology and Surgery,Linyi Tumor Hospital,Shandong,Linyi 276000,China;Special Hemangioma Specialty Department,Linyi Tumor Hospital,Shandong,Linyi 276000,China)
出处
《中国医药科学》
2025年第18期171-174,179,共5页
China Medicine And Pharmacy
基金
山东省医药卫生科技发展计划项目(2015WS0361)。
关键词
动静脉畸形
心功能不全
血流动力学
围手术期
Arteriovenous malformation
Cardiac insufficiency
Hemodynamics
Perioperative period
作者简介
通讯作者:曲歌曲。
